Thank you all for the great comments made about pumping and nipple shield
use.  I continue to learn and also re-learn from Lactnet as I have for many
years!

 

I would like to reiterate what was said in some of the replies - and that
is: "It depends" when it comes to the use of pumping after using the nipple
shield.

 

Frankly, right after birth, if the nipple shield is used, I see no use to
pumping, as the colostrum does not flow well with most pumps.  I would
encourage hand expression.  This is easiest to learn at this time, before
the breasts are hard and swollen, and she is more likely to be able to learn
"kinesthetically" as she is using her own hand and feels it with her own
breast.  This is more effective than trying to teach how to assemble a piece
of equipment (I used to teach dads and grandparents) and how to use and
clean it. 

 

The concept that we can assess "good milk transfer" with the shield while in
the hospital I find unlikely, as the swallows heard and even the test
weighing may be suspect, unless mom and baby are in the hospital longer than
the usual (in my area) 24 - 36 hours.  

 

Perhaps there could be a way to communicate with moms after discharge by
sending an e-mail with links to websites that show how to assemble and use
that particular pump with instructions to start this pumping when they see
their milk is flowing better?  Just trying to think "outside the box" -
literally!

 

What I am observing in my area is the lack of early EFFECTIVE follow-up -
yes, they see the baby, yes, they weigh the baby, NO ONE observes a
breastfeeding (how can you with appointments that are scheduled and may
likely not coincide with baby's desire to nurse, or with a hysterical baby
who cannot be calmed in the 15-minute slot they are given?).  What is worse,
there is not another appointment for 2 weeks (if she's lucky) or longer!

 

SOOO - my answer to your question about having moms use breast pumps when
initially using nipple shields is: "it depends" on your own areas' follow-up
system and the mom's ability to get to them. (We also have no good
transportation!)  A great topic for a community breastfeeding coalition
discussion, as well as one within your own hospital staff and staff that
receive your babies for postpartum and pediatric care.    

 

By the way, do you have moms calling saying the box said to not use the
nipple shield for more than 3 days.so they threw it away and now want to
know where to buy another one?   Getting that a few of those lately!  Great
marketing plan!  (Of course I would love to have a mom evaluated and
encouraged to stop using the shield, but it has to be after observing that
whatever caused the initial indication to use one has now been addressed!

 

Jeanette Panchula, LLLLeader, RN, PHN, IBCLC

Vacaville, CA

 


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